Gall Bladder Visualization and Jaundice.

Abstract

In this study we were interested in 2 questions: (1) Does tetraiodophenolphthalein when present in the gall bladder disappear following obstruction of the common bile duct on the ingestion of meals containing fat? (2) What is the effect of existing obstructive jaundice on the visualization of the gall bladder? To answer the first question the gall bladders of 5 dogs were visualized with tetraiodophenolphthalein, the common bile duct was ligated and meals containing fat were given daily. This is a repetition of the experiment of Copher. 1 It was found that the shadow becomes more dense for 2 or 3 days following the ligation of the common bile duct and this density is maintained as long as 2 weeks after the ligation. We did not follow any of the dogs for a longer period. These findings confirm those of Copher.

To answer the second question the common bile ducts of 5 dogs were ligated, and from 60 to 96 hours later the tetraiodophenolphthalein was injected. It was found that in 2 dogs the gall bladder was faintly perceptible in 14 hours, in one dog in 22 hours, and in the 2 others in 50 hours. At later periods up to 114 hours, the shadow slowly became more visible, but “normal density” was not obtained in any of the dogs. In each of these dogs the gall bladder was visualized and evacuated with egg yolk prior to common duct ligation. The presence of jaundice did not increase the toxicity of the dye.

It has been maintained by some writers 2 that the bile which enters the gall bladder is normally resorbed in toto. If this were true, it would be possible to claim that the disappearance of the gall bladder shadow on the ingestion of a meal is due not to evacuation of the gall bladder, but to increased resorption of the dye.